Sclerotherapy is a common, minimally invasive medical procedure used to treat spider veins and small varicose veins, primarily on the legs. Although the treatment involves injections, the procedure is widely considered manageable and well-tolerated by most people. The discomfort level is highly individual and varies based on the veins being treated. Patients should expect temporary sensations during and after the treatment, which are typically mild and do not require strong prescription pain relief.
What Sclerotherapy Involves
This in-office procedure uses a very fine needle to deliver a specialized chemical, known as a sclerosant, directly into the targeted vein. The sclerosant can be administered as a liquid solution or as a foam, depending on the vein’s size and location. The chemical irritates the lining of the blood vessel, a process called endosclerosis. This controlled irritation causes the vein walls to swell, collapse, and seal shut, blocking the flow of blood. The body then gradually absorbs the closed vein, rerouting blood flow through healthier vessels.
The Sensation During Injection
The acute sensation during sclerotherapy is brief and generally mild, often lasting only a few seconds per injection. When the ultrafine needle pierces the skin, patients may feel a slight pinch, similar to a flu shot or a standard blood draw. The most distinct sensation occurs as the sclerosant solution is introduced into the vein. This can manifest as a momentary sharp sting, a mild burning feeling, or a tingling sensation at the injection site.
For larger varicose veins, the introduction of the solution may cause a brief cramping sensation that can last for a minute or two as the vein spasms and begins to close. The specific type of sclerosant used can also influence the sensation. Any intense pain during the injection should be immediately communicated to the provider, as it could indicate the solution has leaked outside the vein.
Post-Procedure Discomfort and Healing
After the procedure, the immediate sensations shift into a period of expected discomfort as the healing process begins. Common symptoms include mild aching, tenderness, and a feeling of tightness, often due to the required compression stockings. Bruising around the injection sites is typical and can last for several days or up to two weeks.
The treated veins may initially feel firm, raised, or lumpy beneath the skin as they begin to scar and close down. Some patients also experience mild swelling and redness near the treated areas, which generally subsides within the first week.
Pain Management and Realistic Expectations
Managing post-procedure discomfort focuses on supporting the body’s healing process and alleviating mild pain. Over-the-counter pain relievers, such as acetaminophen, are recommended. Patients are advised to avoid nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or aspirin for at least 48 hours. These medications can interfere with the inflammation required for the sclerosant to close the vein.
The most effective management tool is the use of medical-grade compression garments, which should be worn as directed. Compression reduces swelling and minimizes aching by preventing blood from pooling. Gentle movement, particularly walking, is encouraged immediately after the procedure to promote healthy circulation. Most post-treatment discomfort resolves within a few days, but the treated veins will continue to fade over several weeks to months.